MEDICARE: SAVIOR HEALTH CARE SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		TX
2	311ZA0620X	Adult Care Home Facility		TX

General Provider Information

NPI Number	:	1972047249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAVIOR HEALTH CARE SERVICES INC

Provider Business Mailing Address
First Line	:	3628 REDSTART DR
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75181-4300
Country	:	US
Telephone Number	:	214-647-1551
Fax Number	:	214-647-1551

Provider Business Practice Location Address
First Line	:	3628 REDSTART DR
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75181-4300
Country	:	US
Telephone Number	:	214-647-1551
Fax Number	:	214-647-1551

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KATE NWIKE
Credential	:	NP
Telephone Number	:	214-647-1551

Provider Enumeration Date	:	12/06/2016
Last Update Date	:	12/07/2016

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